Kornimate/medical-research-clean huggingface dataset:
botox injection in treatment of chronic migraine

Conditions: Migraine Disorders

Summary: chronic migraine is in many cases a most disabling condition. chronic migraine is defined as headaches for at least 15 days per month, of which 8 days have typical migraine features. in many cases, oral drug treatment has little effect. the parasympathetic nervous system acting through the sphenopalatine ganglion may be involved in several primary headaches, including migraine, by facilitating release of inflammatory substances in cerebral vessels. botulinum toxin type a (bta) inhibits excretion of acetylcholine resulting in blocking of nerve signals in the sphenopalatine ganglion. the purpose of the present study is to evaluate a new technique with injection of bta using an minimal invasive image guided procedure, for blocking of the sphenopalatine ganglion. the goal is to relieve the migraine symptoms and develop an alternate treatment for cases where oral drug treatments fail. the main objective of the project is to determine the safety of this method of bta injection in the area of the sphenopalatine ganglion by detecting adverse events. secondary objectives are to measure changes in headache attack parameters with this novel method.


Eligibility criteria:
inclusion criteria: * informed and written consent * chronic migraine with or without aura defined in international classification of headache disorders (ichd)-3 criteria * failed at least 3 oral migraine prophylactic treatments * duration of migraine at least 1 year before inclusion * start of migraine before participant turned 50 years * participant can make a distinction between migraine and other types of headache exclusion criteria: * if the criteria for medication-overuse headache (moh) is fulfilled * heart or lung disease * any kind of systematic or local disease or illness that may significantly increase the risk of complications for the procedure related to injection * psychiatric illness that hinders participation in the study * known pregnancy or breast feeding * inadequate use of contraceptives * overuse or abuse of opioids * abuse of medications, narcotics or alcohol * anomalies which hinder or impede the used method of injection * allergy or any other hypersensitivity reactions against marcain, lidocaine, xylocain or adrenalin, botulinum toxin type a, botox or any of it's constituents or any other related medication * treatment with medication that can interact with botulinum toxin type a

Keywords: migraine with aura migraine without aura headache disorders botulinum toxin type a sphenopalatine ganglion block autonomic nerve block
enhancing neonatal sucking reflex: a study on the efficacy of magnesium sulphate in severe birth asphyxia

Conditions: Birth Asphyxia

Summary: children's hospital multan is a tertiary care teaching hospital in south punjab, the poorest and most backward area of punjab, pakistan, where a significant number of newborns suffer from birth asphyxia. therefore, this study was planned with the objective of investigating the effectiveness of magnesium sulphate in severe birth asphyxia, hypothesizing that in cases of birth asphyxia, neonates who are treated with magnesium sulphate have a higher sucking reflex than those who are not treated with magnesium sulphate.


Eligibility criteria:
inclusion criteria: * full-term babies (≥37 weeks of gestation) * both genders * severe birth asphyxia * admitted within six hours of life. exclusion criteria: * premature babies * congenital malformations * babies born to mothers who received general anesthesia * babies whose mothers received magnesium sulfate, pethidine, and other drugs in the past 7 days.
the effect of pulsed electromagnetic field therapy on patients with low back pain

Conditions: Low Back Pain

Summary: this study will examine the effects of a portable of pulsed electromagnetic field (pemf) device (md cure, aerotel, usa) compared with a sham device on patient-reported outcomes of pain and function in patients with either acute/subacute or chronic low back pain (lbp).

this study is a double-blind, placebo-controlled, randomized pilot study comparing usual care + pemf with usual care + sham. the investigators will recruit patients with lbp from the university of bridgeport chiropractic clinic, and will enroll 80 total subjects: 40 with acute or subacute lbp, and 40 with chronic lbp. within each of those populations the investigators will assign 20 subjects to receive usual care + pemf, and 20 to receive usual care + sham. the investigators will track any other treatments initiated or discontinued during the trial. patients who agree to participate with be randomly given a functional pemf device or a sham unit. patients and clinicians will be blinded to the assignment. all subjects will be given the same instructions for daily use of the devices, and will continue to receive usual follow-up at the ubcc clinic as indicated. the investigators will collect patient-reported measures of pain and function pain at baseline, 6 weeks, and 12 weeks, and will collect data on adverse effects at each visit and at 6 and 12 weeks.

Eligibility criteria:
inclusion criteria: * ubcc patient * complaint of lbp intensity 4/10 or greater on the numerical rating scale * diagnosis of a mechanical lbp condition * age 18-70 years * fluency in written and spoken english * for female subjects, be postmenopausal, surgically sterile, abstinent, or agree to practice an effective method of birth control for the duration of the study if sexually active * a willingness to participate in the study as evidenced by a signed informed consent form exclusion criteria: * current lbp complaint of 3/10 or less on the numerical rating scale * diagnosis or suspicion of lbp caused by cancer, infection, referred visceral pain, inflammatory arthropathy, or other non-mechanical process * current or planned pregnancy * any electrically-based implanted devices such as pacemakers defibrillators, spinal cord stimulators, insulin pumps; metallic implants (e.g. surgical fusion constructs, disc replacements) in the low back * status post any lumbosacral spine surgery; significant mental health co-morbidities such as severe depression, schizoaffective disorders, suicidal ideation * inability to understand and/or complete all components of the informed consent process without the assistance of another person (e.g. without proxy) * inability to adhere to and comply with the treatment protocol.
calcium carbonate on labor induction

Conditions: Pregnancy; Uterine Contraction

Summary: the investigators aim to evaluate the safety and efficacy of administering calcium carbonate to laboring participants undergoing labor inductions. the investigators hypothesize that calcium carbonate is a low-risk preventative measure to decrease oxytocin induction time and dosage, decrease the rate of labor dystocia, decrease the rate of cesarean deliveries, and demonstrate no differences in maternal or neonatal safety outcomes.

the investigators plan to assess (1) duration of induction with oxytocin administration, (2) rate of labor dystocia/failed induction, (3) rate of cesarean section, and (4) maternal/neonatal safety. currently, calcium carbonate is used by clinicians in patients with varying characteristics, at varying doses, and at various times in their labor process based on their professional preference and experience. the investigators will implement a standardized treatment protocol for calcium carbonate use within a defined patient population who voluntarily agree to prospectively receive the intervention and then analyze predetermined safety and efficacy outcomes in comparison to a historical cohort of patients meeting the criteria for the defined patient population who did not have any documented calcium carbonate use during labor.

Eligibility criteria:
inclusion criteria: * adult laboring patients ( ≥ 18 years of age) * able to speak and read english or spanish (for historical cohort, preferred language should be english or spanish) * singleton gestation * greater ≥ 37 weeks gestation in vertex presentation * present for induction of labor inclusive of medical indication, elective indication at greater than 39 weeks gestation, trial of labor after cesarean * receive standard-dose oxytocin during induction exclusion criteria: * participants will be excluded from the study if they do not meet the above inclusion criteria or they will be further excluded under the following circumstances: * known need for cesarean section prior to induction of labor * known allergy to calcium carbonate * known contraindication to taking calcium carbonate including renal calculus, high urine calcium levels, elevated serum calcium, low serum phosphate, achlorhydria, or suspected digoxin toxicity. * inability to tolerate oral intake (i.e., nausea/vomiting) * need to be nothing by mouth (npo)

Keywords: pregnancy uterine contraction calcium carbonate labor induction time labor dystocia
error based learning for restoring gait symmetry post-stroke

Conditions: Stroke

Summary: many of the 780,000 people affected by stroke each year are left with slow, asymmetric walking patterns. the proposed project will evaluate the effectiveness of two competing motor learning approaches to restore symmetric gait for faster, more efficient, and safer walking.

walking after stroke is characterized by reduced gait speed and the presence of interlimb spatiotemporal asymmetry. these step length and stance time asymmetries can be energy inefficient, challenge balance control, increase the risk of falls and injury, and limit functional mobility. current rehabilitation to improve gait is based on one of two competing motor learning strategies: minimizing or augmenting symmetry errors during training. conventional rehabilitation often involves walking on a treadmill while therapists attempt to minimize symmetry errors during training. although this approach can successfully improve gait speed, it does not produce long-term changes in symmetry. conversely, augmenting or amplifying symmetry errors has been produced by walking on a split belt treadmill with the belts set at different fixed speeds. while this approach produced an 'after-effect' resulting in step length symmetry for short periods of time, with some evidence of long term learning in people with stroke, it had no influence on stance time asymmetry. the investigators propose that patients need real-time proprioceptive feedback of symmetry errors so that they are actively engaged in the learning process. for this project, the investigators developed and validated a novel, responsive, 'closed loop' control system, using a split-belt instrumented treadmill that continuously adjusts the difference in belt speeds to be proportional to the patient's current asymmetry. using this system, the investigators can either augment or minimize asymmetry on a step-by-step basis to determine which motor learning strategy produces the largest improvement in overground spatiotemporal symmetry.

Eligibility criteria:
inclusion criteria: * ability to walk \>10 m overground without physical assistance * overground comfortable gait speed (cgs) \< 1.0 m/s (using assistive devices and bracing below the knee as needed) * able to walk independently on the treadmill at \>80% cgs * exhibits stance time and/or step length asymmetry during cgs exclusion criteria: * cerebellar lesion * uncontrolled cardiorespiratory/metabolic disease (cardiac arrhythmia, uncontrolled hypertension or diabetes, orthostatic hypertension, chronic emphysema)or other neurological or orthopedic disorders that may affect gait training * botulinum toxin to the lower limb in the past 6 months * a history of balance deficits or unexplained falls not related to the stroke * uncontrolled seizures * concurrent physical therapy * mini-mental status exam (mmse) \< 24 * communication impairments which could impede understanding of the purpose or procedures of the study or an inability to comply with experimental procedures

Keywords: stroke gait walking
increased ketorolac administration after cesarean section and its effect on opioid use: a randomized control trial

Conditions: Post-operative Pain; Post-partum Pain; Cesarean Section Complications

Summary: to evaluate the efficacy of increased ketorolac in reducing opioid use after cesarean section.

this was a single-center, randomized, double-blind, parallel-group trial to assess pain management following cesarean section with increased ketorolac versus placebo. all patients undergoing cesarean section with neuraxial anesthesia received two doses of 30mg iv ketorolac postoperatively per hospital protocol and were then randomized to receive an additional four doses of 30 mg of iv ketorolac or placebo every 6 hours. the primary outcome was the total morphine milligram equivalents (mme) used in the first 72 postoperative hours. secondary outcomes included the number of patients that used no opioid postoperatively, postoperative pain scores, postoperative change in hematocrit and creatinine, and postoperative satisfaction with inpatient care and pain management. a sample size of 74 per group (n=148) was planned.

Eligibility criteria:
inclusion criteria: * women presenting for care at tufts medical center as an outpatient in obstetrics clinic or on labor and delivery. * the subject must have had a cesarean section for any indication at tufts medical center to be randomized to the study * the subject is willing to have a phone call follow up conversation 2 weeks after their surgery. exclusion criteria: * patients with allergy to ketorolac, nsaids or aspirin * patients with peptic ulcer disease, preexisting kidney or liver disease. * duramorph is not used as the anesthetic for the spinal/epidural during the cesarean section. * patient is hemodynamically unstable due to hemorrhage. * patient requires therapeutic anticoagulation in the post-operative period * patients with peripartum cardiomyopathy * provider decision to exclude patient. * patient diagnosis of chronic hypertension, gestational hypertension, preeclampsia, hellp syndrome, or eclampsia * a study subject may participate in another research study while participating in this research study.

Keywords: ketorolac opiate cesarean section
myhealthcheckup wellness program among canadian forces military personnel

Conditions: Overweight

Summary: this research is collecting data to determine the benefits of a web-based wellness program designed to improve the health and well-being of individuals in the workplace. participants will be invited to participate in a web-based healthy weight program. the program is designed to optimize health and wellbeing by promoting physical activity and healthy eating.


Eligibility criteria:
inclusion criteria: * a military member of the canadian forces base in halifax exclusion criteria: -

Keywords: weight loss healthy weight overweight body mass index greater that 25 kg/m2
avai: atrial ventricular arrythmia incidence

Conditions: Ventricular Tachycardia; Atrial Fibrillation

Summary: the purpose of this observational study is to collect data regarding the population of patients implanted with st. jude medical icd.

the purpose of this observational study is to collect data regarding the population of patients implanted with a st. jude medical icd. data regarding slow ventricular tachycardia episodes, atrial fibrillation episodes and the devices programmed parameters will be collected during two years after the implant.

Eligibility criteria:
inclusion criteria: * patient has been implanted with a st jude medical icd, mono,bicameral or cardiac resynchronization therapy - defibrillator (crt-d) according the american college of cardiology (acc), american heart association (aha), national standards for physical education (naspe) guidelines. (min. 24 hours - max. 2 months) * patient has signed the study specific informed consent document. * patient is older than 18 years of age exclusion criteria: * patient has a permanent atrial fibrillation * patient has a documented slow ventricular tachycardia episodes previous to the icd implant. * patient not programed with a ventricular tachycardia (vt) zone upper than 120 bpm. * patient requires cardiac resynchronization * patient has brugada syndrome * patient has long qt syndrome * patient has a device replacement; * patient is pregnant or nursing * patient is unable to attend the follow-up visits
the association of microbiota composition with cgvhd after allo-hsct

Conditions: Hematopoietic Stem Cell Transplantation; Hematologic Malignancy; Chronic Graft-versus-host-disease; Complication

Summary: previous studies had found that the microbe in intestinal after allogeneic hematopoietic cell transplantation(allo-hsct) were closely associated with overall survival and post-transplantation complications, especially graft versus host disease (gvhd).due to the limited data on the association of microbiota composition with chronic gvhd(cgvhd) after allogeneic hematopoietic stem cell transplantation, the relationship between microbiota composition and post-transplantation complications, especially cgvhd, needs to be further evaluated.detailed studies of the microbiome and host immune system will lead to the discovery of microbiome markers for early identification of patients at high risk for cgvhd. this may regulate patients' gut microbiota in an individualized manner to achieve optimal treatment outcomes while avoiding severe post-transplant cgvhd. we will operate a prospective, multicenter, nonrandomized, observational study. patients will be asked to provide blood and stool samples during allo-hsct.

previous studies had found that the microbe in intestinal after allogeneic hematopoietic cell transplantation(allo-hsct) were closely associated with overall survival and post-transplantation complications, especially graft versus host disease (gvhd).due to the limited data on the association of microbiota composition with chronic gvhd(cgvhd) after allogeneic hematopoietic stem cell transplantation, the relationship between microbiota composition and post-transplantation complications, especially cgvhd, needs to be further evaluated.detailed studies of the microbiome and host immune system will lead to the discovery of microbiome markers for early identification of patients at high risk for cgvhd. this may regulate patients' gut microbiota in an individualized manner to achieve optimal treatment outcomes while avoiding severe post-transplant cgvhd. we will operate a prospective, multicenter, nonrandomized, observational study. patients will be asked to provide blood and stool samples during allo-hsct. this blood will be used for plasma banking for further analysis, including mir, chemokine and metabonomics detection. stool will be used for microbiome studies - isolation of total dna/rna and 16s rrna gene sequencing for bacterial taxonomic classification. furthermore, metagenomic sequencing and subsequent taxonomic and functional classification of microbial genes will be used.

Eligibility criteria:
inclusion criteria: 1. aged between 18 years and 65 years 2. patients planned to be treated by allogeneic hematopoietic cell transplantation 3. signed written informed consent exclusion criteria: patients not-matching inclusion criteria

Keywords: hematopoietic stem cell transplantation microbiota metabolomics chronic graft versus host disease
mediterranean diet, circuit resistance training, empagliflozin in elderly with type 2 diabetes: a study protocol

Conditions: Diabetes Mellitus, Type 2; Sarcopenia; Weight Loss; Frailty

Summary: primary objective: to assess the effects of a modified plant-based mediterranean diet (vegeterranean diet), circuit resistance training (crt) and empagliflozin alone or in combination on body composition and physical function in elderly subjects with type 2 diabetes. the rationale for this study is to assess three interventions associated with a negative energy/caloric balance (increased caloric use in exercise, caloric restriction in the vegeterranean diet and caloric wasting by glycosuria with empagliflozin), their interaction and effect on body composition and physical function. methods and analysis: one hundred and twenty men and women ≥ 65 years of age with type 2 diabetes, and low levels of physical activity will be randomized (1:1:1 manner, gender-stratified) for 10 weeks to one of 3 parallel arms: crt consisting of 3 home sessions/week; ad-libitum plant-based mediterranean diet (limited consumption of eggs, dairy and fish, avoidance of red meat and poultry) or empagliflozin 10mg/day. after 10 weeks crt will be added to the empagliflozin or diet arms for an additional 10 weeks. allocation concealment and blinding of primary outcome assessors will be implemented. efficacy will be determined by assessment of lean body mass, body weight, frailty status, sarcopenia, hba1c and quality of life questionnaires. safety will be evaluated by routine monitoring of adverse events. this study was approved by the tel-aviv sourasky medical center institutional review board


Eligibility criteria:
inclusion criteria: subjects who have type 2 diabetes mellitus in accordance with american diabetes association guidelines and: 1. are ≥65 years of age (inclusive) on the day of signing the informed consent form. 2. perform \<2 days a week of any leisure aerobic physical activity (pa), who are able to walk independently either with or without an assistance device (cane or walker). 3. hba1c ≥6.5% to ≤8%. exclusion criteria: 1. recent use of steroid agents (\<6 months, replacement therapy is allowed) 2. uncorrected hypothyroidism \[thyroid stimulating hormone (tsh) \> 6 mlu/l\] 3. diagnosis of malignancy within the past 5 years except for non-melanoma skin cancer. 4. severe kidney disease (egfr\<45cc/ml) 5. active depression 6. recent (≤6 months) or unstable cardiovascular condition; new york heart association (nyha) class 3 or higher congestive heart failure; 7. subjects with pa limiting pain due to neuropathy 8. subjects who are in an active nutritional therapy changed their diet recently (\<1 month) and/or in a weight-loss program (actively losing weight). 9. has other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or may interfere with the interpretation of study results.

Keywords: weight loss; diabetes; frailty; sarcopenia
stroke imaging package study

Conditions: Acute Ischemic Stroke; Intracranial Arteriosclerosis; Cerebral Small Vessel Diseases

Summary: our study aims to explore the value of new imaging technique package in predicting early neurological deterioration (end) as well as 90-day unfavorable outcome in patients with acute ischaemic stroke.

1. patients with acute ischemic stroke within 4.5-72h after onset were prospectively enrolled in our study and underwent standardized clinical and new imaging technique package assessment. 2. new imaging technique package mainly includes conventional cranial mri （t1,t2,t2 flair,dwi, and adc), cranial magnetic resonance angiography (mra), and intracranial vessel wall imaging (high-resolution magnetic resonance imaging,hrmri) as well as susceptibility weighted imaging (swi). 3. the neurofunctional fluctuation during hospitalization as well as 90-day outcomes were carefully assessed. patients were followed up for 90-days after stroke onset. 4. our study aims to explore the value of new imaging technique package in predicting early neurological deterioration (end) as well as 90-day unfavorable outcome in patients with acute ischaemic stroke.

Eligibility criteria:
inclusion criteria: 1. patients with ischemic stroke and hospitalized during 4.5-72 hours after onset , confirmed by diffusion weighted imaging (dwi). 2. patients with stable vital signs. 3. patients who have underwent thrombolytic/intravascular therapy are allowed to enroll in the study. exclusion criteria: 1. patients with absolute/relative contraindication to mri (including but not confined to metal in the body and claustrophobia). 2. patients who is extremely agitated, and cannot comply with mri exam. 3. patients who declined the consent.

Keywords: ais icas csvd